1492. Chlamydia, Gonorrhea, Syphilis and HIV Screening among Men Presenting with STI-Related Complaints at a Community-Based Emergency Department in Columbus, Ohio: A 5-Year Retrospective Study

Abstract

BackgroundSexually transmitted infections (STIs) disproportionally affect individuals living in poor and underserved areas of the United States. Emergency Departments (ED) are often the only point of healthcare access for these at-risk individuals. As such, the ED often serves a key role in STI screening. The purpose of this study was to review STI screening practices for men at an urban and community-based ED affiliated with a large academic medical center in Columbus, Ohio.MethodsRetrospective review of all ED visits from January 2012 to December 2017. A total of 279,929 patient-visits were analyzed for male patients by (1) exposure to an STI (2) STI-related symptoms (penile discharge/pain, scrotal/testicular pain/swelling). We analyzed the demographic characteristics of men who presented to the ED with an STI-related complaint and compared those who underwent STI screening (chlamydia, gonorrhea, syphilis or HIV) to those that did not.ResultsTable 1.Men with STI-Related Chief Complaints (n = 3,281)Any STI Testing Done 2,274 (69.4%)No STI Testing Done 1,003 (30.6%)Race Black2,112 (92.8%)809 (80.6%) White109 (4.7%)138 (13.7%) Other53 (2.3%)56 (5.5%)Median age (IQR)30 (23–44)27 (23–36)Presenting Complaint Males exposed to STI 1,459 (14.9%)1,120 (76.8%)339 (23.2%) Males with symptoms 1,809 (20.9%)1,154 (63.8%)655 (36.2%)ConclusionOver a 5-year period, screening for chlamydia, gonorrhea for men presenting with STI-related complaints was adequate. However, syphilis and HIV screening was very low among men presenting to an urban and community-based ED with an STI-related complaint. A separate analysis for women is being done. There is an urgent need to identify and eliminate barriers to syphilis and HIV screening in ED’s that serve at-risk populations.Testing Done (n = 2,274)Chlamydia2,269 (99.7%)Gonorrhea2,267(99.6%)Syphilis33 (1.4%)HIV1 (<0.1%)Disclosures All authors: No reported disclosures.